| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.24 | $38.24 | $38.24 | |
Aetna
| Professional | $28.67 | $38.24 | $38.24 | |
Cigna
| Facility | $1,148.73 | $1,471.42 | $1,972.05 | |
Kaiser Permanente
| Professional | $32.44 | $38.40 | $71.12 | |
United
| Professional | $23.65 | $40.97 | $106.20 |